Effects of Intravenous Fluid Restriction on Postoperative Complications

2018 ◽  
pp. 119-124
Keyword(s):  
Body Weight ◽  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Intravenous Fluid ◽  
Standard Group ◽  
Fluid Restriction ◽  
Standard Regimen ◽  
Elective Colorectal Surgery ◽  
Thoracic Epidural ◽  
Fluid Regimen

This case focuses on the effects of limiting intravenous fluids on postoperative complications by asking the question: What are the effects of a restricted intravenous fluid regimen targeting an unchanged body weight vs. a standard regimen on complications after elective colorectal surgery? Patients receiving combined thoracic epidural and general anesthesia were randomized to two groups: the restricted fluid regimen and the standard fluid regimen. A total of 141 patients completed the trial: 69 in the restricted group and 72 in the standard group. This randomized, observer-blinded clinical trial demonstrated that a restricted intravenous fluid regimen aimed at unchanged body weight reduced complications after elective colorectal surgery.

Randomized clinical trial of the effect of postoperative intravenous fluid restriction on recovery after elective colorectal surgery

2006 ◽  
Vol 93 (12) ◽  
pp. 1469-1474 ◽  
Author(s):  
G. MacKay ◽  
K. Fearon ◽  
A. McConnachie ◽  
M. G. Serpell ◽  
R. G. Molloy ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Colorectal Surgery ◽  
Randomized Clinical Trial ◽  
Intravenous Fluid ◽  
Fluid Restriction ◽  
Elective Colorectal Surgery

Frailty predicts severe postoperative complications after elective colorectal surgery

2019 ◽  
Vol 217 (4) ◽  
pp. 677-681 ◽  
Author(s):  
Hirohisa Okabe ◽  
Takayuki Ohsaki ◽  
Katsuhiro Ogawa ◽  
Nobuyuki Ozaki ◽  
Hiromitsu Hayashi ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Elective Colorectal Surgery

scholarly journals 129 Compliance with The ERAS Protocol Amongst Colorectal Surgery Junior Doctors at Gloucester Royal Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Brennan
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Intravenous Fluid ◽  
Junior Doctors ◽  
Intravenous Fluids ◽  
Elective Colorectal Surgery ◽  
Royal Hospital ◽  
Elective Surgical Procedures ◽  
Eras Protocol

Abstract Background Enhanced recovery after surgery (ERAS) is an evidence-based protocol aiming to expedite recovery following elective surgical procedures. ERAS has shown to reduce the length of hospital stay, complications, readmissions, and costs. The junior doctor’s role in ERAS centres around admission, preoperative nutritional care, and ERAS compliance. This audit aimed to review prescribing of perioperative nutritional drinks (NutriciaPreop© and Fortisips) and intravenous fluids for patients undergoing elective colorectal surgery at Gloucester Royal Hospital. Method An 80% standard was set for this audit. A full audit cycle was completed. Drug and intravenous fluid charts were analysed for correct prescribing of NutriciaPreop© and intravenous fluids pre-operatively, and peri operative Fortisips. Improvement measures included ward posters and education to incoming junior doctors. Results Initial data collection showed that 70% of patients received a correct intravenous fluid prescription pre-operatively. 24% of patients were prescribed NutriciaPreop© and 18% were prescribed Fortisips. During re-auditing intravenous fluids were correctly prescribed in 80% of patients, NutriciaPreop© in 67% of patients and Fortisips in 60%. Conclusions This audit emphasises the importance of good quality inductions for junior doctors and how simple measures improve prescribing of essential peri-operative nutrition. Additionally, the value of multidisciplinary team involvement in junior doctor training has been highlighted.

scholarly journals Effects of Intravenous Fluid Restriction on Postoperative Complications: Comparison of Two Perioperative Fluid Regimens

2003 ◽  
Vol 238 (5) ◽  
pp. 641-648 ◽  
Author(s):  
Birgitte Brandstrup ◽  
Hanne Tønnesen ◽  
Randi Beier-Holgersen ◽  
Else Hjortsø ◽  
Helle Ørding ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intravenous Fluid ◽  
Fluid Restriction

scholarly journals Preoperative C-reactive protein and other inflammatory markers as predictors of postoperative complications in patients with colorectal neoplasia

2021 ◽  
Author(s):  
Sufana Alsaif ◽  
Ailín C Rogers ◽  
Priscilla Pua ◽  
Paul T Casey ◽  
Geoff G Aherne ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Inflammatory Markers ◽  
Postoperative Morbidity ◽  
Colorectal Neoplasia ◽  
Full Blood Count ◽  
C Reactive Protein ◽  
Elective Colorectal Surgery ◽  
Reactive Protein ◽  
Grade 3

Abstract Background: Inflammatory markers are measured following colorectal surgery to detect postoperative complications. However, the association of these markers preoperatively with subsequent postoperative course has not yet been usefully studied. Aim: The aim of this study is to assess the ability of preoperative C-reactive protein (CRP) and other inflammatory marker measurements in the prediction of postoperative morbidity after elective colorectal surgery. Methods: This retrospective study catalogues 218 patients undergoing elective, potentially-curative surgery for colorectal neoplasia. Preoperative laboratory results of the full blood count (FBC), C-reactive protein (CRP) and carcinoembryonic antigen (CEA) were recorded. Multivariable analysis was performed to examine preoperative variables against 30-day postoperative complications by type and grade (Clavien-Dindo (CD)), adjusting for age, sex, BMI, smoking status, medical history, open versus laparoscopic operation, and tumor characteristics. Results: Elevated preoperative CRP (≥ 5 mg/L) was significantly predictive of all-cause mortality, with an OR of 17.0 (p < 0.001) and was the strongest factor to predict a CD morbidity grade ≥ 3 (OR 41.9, p < 0.001). Other factors predictive of CD morbidity grade ≥ 3 included smoking, elevated preoperative platelet count and elevated preoperative neutrophil-lymphocyte ratio (OR 15.6, 8.6 and 6.3 respectively, all p < 0.05). CRP values above 5.5 mg/L were indicative of all-cause morbidity (AUC=0.871), and values above 17.5 mg/L predicted severe complications (AUC=0.934). Conclusions: Elevated preoperative CRP predicts increased postoperative morbidity in this patient cohort. The results herein aid risk and resource stratification and encourage preoperative assessment of inflammatory propensity besides simple sepsis exclusion.

scholarly journals Thrombocytosis as a Marker for Postoperative Complications in Colorectal Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
M. Mohamud ◽  
L. Osborne ◽  
H. G. Jones ◽  
A. Ahmed ◽  
J. Beynon ◽  
...  
Keyword(s):  
Platelet Count ◽  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Surgical Complications ◽  
Incidental Finding ◽  
Blood Platelet ◽  
Prognostic Indicator ◽  
Categorical Variables ◽  
Elective Colorectal Surgery ◽  
Positive Correlation

Background. Blood platelet measurement is a widely available and inexpensive test that is performed routinely. Platelets are thought to act by inducing inflammation and play a role in clotting and antimicrobial defence. A postoperative rise in the platelet count (thrombocytosis) is often dismissed as an incidental finding, but there is growing evidence to suggest that it may act as an indicator to underlying pathology. It correlates with significant pyogenic infections as well as multiple malignancies. In addition to this, recent research indicates that thrombocytosis may be a useful prognostic indicator for postoperative outcomes in patients with malignancies. In patients undergoing surgery for gastric cancer, a combination of platelet count and neutrophil-to-lymphocyte (NLR) ratio collected preoperatively was shown to correlate with postoperative survival. Objective. To evaluate whether there is a positive correlation between pre- and postoperative thrombocytosis and the risk of complications following colorectal surgery. Methods. This was a retrospective observational study based in Morriston Hospital, Swansea. Patients undergoing elective colorectal surgery for an 18-month period between 2014 and 2016 were included. Data on patient demographics, pre- and postoperative platelet count, the first date at which the highest platelet count was recorded, length of stay, type of operation, and postoperative complications using the Clavien-Dindo classification was obtained from the theatre booking software (TOMS) and Welsh Clinical Portal. Pearson’s chi-square test was used for the analysis of the categorical variables. Results. Of the 201 patients studied, 75 (37%) had postoperative thrombocytosis (platelets ≥ 500 × 109/L, range 501–1136), 120 (59%) had postoperative normocytosis (platelets < 500 × 109/L, range 107–499), and 6 (2.9%) patients were excluded due to insufficient data. Peak platelet level was seen at a median of 8 days postoperatively but ranged from days 1 to 49. In patients with thrombocytosis, the mean time to peak platelet count was 9.5 days and ranged 1 to 49 days. 101/195 (52%) patients had a Clavien-Dindo III/V postoperative complication: 63% patients with postoperative normocytosis and 24% with postoperative thrombocytosis. In the thrombocytosis group, 16/75 (21%) were found to have postoperative pelvic collections compared to 1/120 (0.8%) of the normocytic patients. The total percentage of medical complications (44% versus 20%, p=0.006) and surgical complications (64% versus 15.8%, p=0.0001) was higher in the thrombocytosis group compared to the normocytosis group. Conclusion. In this retrospective study, thrombocytosis was shown to have a positive correlation with postoperative medical and surgical complications. An elevated platelet count in the postoperative period should alert the clinician to a developing complication. We recommend that further studies with a larger sample size would test the specific associations with individual complications.

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